PRIMARY CONVENIENT CARE CORPORATION NPI 1558951392

NPI Information

  • NPI: 1558951392
  • Provider Name: PRIMARY CONVENIENT CARE CORPORATION
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 36D2241524
  • Address: 3763 EAST MAIN STREET
    NEW WATERFORD, OH
    ZIP 44445
  • Phone: (330) 420-2025

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NPI Details

PRIMARY CONVENIENT CARE CORPORATION is a primary care clinic center in New Waterford, OH. PRIMARY CONVENIENT CARE CORPORATION NPI is 1558951392. The provider is registered as an organization entity type.

The provider's business location address is:

3763 EAST MAIN STREET
NEW WATERFORD, OH
ZIP 44445-001
Phone: (330) 420-2025
Fax: (330) 967-4444

The provider's authorized official is Brooke Boyd .
The authorized official title is Co Owner and has the following contact phone number (330) 853-7086.

The CLIA number assigned to this NPI record is 36D2241524 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/26/2021 and was last updated on 3/1/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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